Kinematics of the human pelvis following open book injury

The objective of this study is to determine the three dimensional kinematics of the human pelvis including both sacroiliac joints following a simulated open book injury induced on cadavers by applying anterior-posterior compressive loads to the pelvis. An electromagnetic digitizing and motion tracking system was utilized to measure the morphology of the pelvis and the relative movements of its bones during this simulated open book fracture. The screw displacement axis method was used to describe the relative motion between the sacrum and each hipbone. Morphologically, it was found that the articular surfaces forming the sacroiliac joints could be approximated with planar surfaces directed from proximal and lateral to distal and medial and from posteromedial to anterolateral. The kinematic data obtained from this study indicate that there is a direct correlation between the opening of the symphysis pubis and the opening of the sacroiliac joint (SIJ) during open book injury. This suggests that the extent of injury of the SIJ maybe estimated from the degree of opening of the symphysis pubis as demonstrated on anteroposterior (A-P) x-rays. The results obtained from this study also indicate that the motion of the hipbone with respect to the sacrum on the side of the sacroiliac joint opening is almost a pure rotation, which translates clinically on the A-P x-rays as pure opening of the SIJ without vertical displacement. The average axis of rotation was found to be almost parallel to the SIJ planar articular surface. Furthermore, the pubic bone on the side of SIJ opening was found to displace inferiorly and posteriorly. One can thus conclude that in open book pelvic injuries, the pubic bone on the side of injury displaces inferiorly on the outlet projection x-rays with no vertical displacement of the SIJ. This is important since the initial assessment of the open book injury in the emergency room includes outlet projection x-rays. From this study, the relative vertical positions of the pubic bones on these x-rays can help the surgeon in differentiating open book fracture injury from other pelvic injuries.     

Changes in intra-abdominal pressure,trunk muscle activation and force during isokinetic lifting and lowering

Intra-abdominal pressure (IAP), force and electromyographic (EMG) activity from the abdominal (intra-muscular) and trunk extensor (surface) muscles were measured in seven male subjects during maximal and sub-maximal sagittal lifting and lowering with straight arms and legs. An isokinetic dynamometer was used to provide five constant velocities (0.12–0.96 m·s^–1) of lifting (pulling against the resistance of the motor) and lowering (resisting the downward pull of the motor). For the maximal efforts, position-specific lowering force was greater than lifting force at each respective velocity. In contrast, corresponding IAPs during lowering were less than those during lifting. Highest mean force occurred during slow lowering (1547 N at 0.24 m·s^–1) while highest IAP occurred during the fastest lifts (17.8 kPa at 0.48–0.96 m·s^–1). Among the abdominal muscles, the highest level of activity and the best correlation to variations in IAP (r=0.970 over velocities) was demonstrated by the transversus abdominis muscle. At each velocity the EMG activity of the primary trunk and hip extensors was less during lowering (eccentric muscle action) than lifting (concentric muscle action) despite higher levels of force (r between –0.896 and –0.851). Sub-maximal efforts resulted in IAP increasing linearly with increasing lifting or lowering force (r=0.918 and 0.882, respectively). However, at any given force IAP was less during lowering than lifting. This difference was negated if force and IAP were expressed relative to their respective lifting and lowering maxima. It appears that the IAP increase primarily accomplished by the activation of the transversus abdominis muscle can have the dual function of stabilising the trunk and reducing compression forces in the lumbar spine via its extensor moment. The neural mechanisms involved in sensing and regulating both IAP and trunk extensor activity in relation to the type of muscle action, velocity and effort during the maximal and sub-maximal loading tasks are unknown.     

Observations on intra-abdominal pressure and patterns of abdominal intra-muscular activity in man.

The aim was to investigate possible relationships between activities of the individual muscles of the ventrolateral abdominal wall and the development of pressure within the abdominal cavity. Intra-muscular activity was recorded bilaterally from transversus abdominis, obliquus internus, obliquus externus and rectus abdominis with fine-wire electrodes guided into place using real-time ultrasound. Intra-abdominal pressure was measured intragastrically using a micro tip pressure transducer. Six males were studied during loading and movement tasks with varied levels of intra-abdominal pressure. During both maximal voluntary isometric trunk flexion and extension, transversus abdominis activity and intra-abdominal pressure remained constant, while all other abdominal muscles showed a marked reduction during extension. When maximal isometric trunk flexor or extensor torques were imposed upon a maximal Valsalva manoeuvre, transversus abdominis activity and intra-abdominal pressure remained comparable within and across conditions, whereas obliquus internus, obliquus externus and rectus abdominis activities either markedly increased (flexion) or decreased (extension). Trunk twisting movements showed reciprocal patterns of activity between the left and right sides of transversus abdominis, indicating an ability for torque development. During trunk flexion--extension, transversus abdominis showed less distinguished changes of activity possibly relating to a general stabilizing function. In varied pulsed Valsalva manoeuvres, changes in peak intra-abdominal pressure were correlated with mean amplitude electromyograms of all abdominal muscles, excluding rectus abdominis. It is concluded that the co-ordinative patterns shown between the muscles of the ventrolateral abdominal wall are task specific based upon demands of movement, torque and stabilization. It appears that transversus abdominis is the abdominal muscle whose activity is most consistently related to changes in intra-abdominal pressure.     

Observations on intra-abdominal pressure and patterns of abdominal intra-muscular activity in man

Cresswell , A. G., Grundström , H. & Thorstensson , A. 1992. Observations on intra-abdominal pressure and patterns of abdominal intra-muscular activity in man. Actri Physiol Scand 144 , 409418. Received 16 July 1 991 , accepted 11 October 1991. ISSN 0001–6772. Department of Physiology III, Karolinska Institute, and Department of Radiology, Danderyd Hospital, Stockholm, Sweden. The aim was to investigate possible relationships between activities of the individual muscles of the ventrolateral abdominal wall and the development of pressure within the abdominal cavity. Intra-muscular activity was recorded bilaterally from transversus abdominis, obliquus internus, obliquus externus and rectus abdominis with fine-wire electrodes guided into place using real-time ultrasound. Intra-abdominal pressure was measured intragastrically using a micro tip pressure transducer. Six males were studied during loading and movement tasks with varied levels of intra-abdominal pressure. During both maximal voluntary isometric trunk flexion and extension, transversus abdominis activity and intra-abdominal pressure remained constant, while all other abdominal muscles showed a marked reduction during extension. When maximal isometric trunk flexor or extensor torques were imposed upon a maximal Valsalva manoeuvre, transversus abdominis activity and intra-abdominal pressure remained comparable within and across conditions, whereas obliquus internus, obliquus externus and rectus abdominis activities either markedly increased (flexion) or decreased (extension). Trunk twisting movements showed reciprocal patterns of activity between the left and right sides of transversus abdominis, indicating an ability for torque development. During trunk flexion-extension, transversus abdominis showed less distinguished changes of activity possibly relating to a general stabilizing function. In varied pulsed Valsalva manoeuvres, changes in peak intra-abdominal pressure were correlated with mean amplitude electromyograms of all abdominal muscles, excluding rectus abdominis. It is concluded that the coordinative patterns shown between the muscles of the ventrolateral abdominal wall are task specific based upon demands of movement, torque and stabilization. It appears that transversus ahdominis is the abdominal muscle whose activity is most consistently related to changes in intra-abdominal pressure.     

Effects of age and inactivity due to prolonged bed rest on atrophy of trunk muscles

This study investigated the effects of age and inactivity due to being chronically bedridden on atrophy of trunk muscles. The subjects comprised 33 young women (young group) and 41 elderly women who resided in nursing homes or chronic care institutions. The elderly subjects were divided into two groups: independent elderly group who were able to perform activities of daily living involving walking independently (n = 28) and dependent elderly group who were chronically bedridden (n = 13). The thickness of the following six trunk muscles was measured by B-mode ultrasound: the rectus abdominis, external oblique, internal oblique, transversus abdominis, thoracic erector spinae (longissimus) and lumbar multifidus muscles. All muscles except for the transversus abdominis and lumbar multifidus muscles were significantly thinner in the independent elderly group compared with those in the young group. The thicknesses of all muscles in the dependent elderly group was significantly smaller than that in the young group, whereas there were no differences between the dependent elderly and independent elderly groups in the muscle thicknesses of the rectus abdominis and internal oblique muscles. In conclusion, our results suggest that: (1) age-related atrophy compared with young women was less in the deep antigravity trunk muscles than the superficial muscles in the independent elderly women; (2) atrophy associated with chronic bed rest was more marked in the antigravity muscles, such as the back and transversus abdominis.     

Electromyographic activity of selected trunk muscles during stabilization exercises using a gym ball

Trunk stabilization is very important for the injured lower back. The use of a gym ball, the surface of which is labile, is becoming more popular for strengthening the trunk muscles and challenging the motor control system in trunk stabilization exercises. However, little is known about the activity of the trunk muscles during such exercises. The purpose of this study was to compare the electromyographic (EMG) activity of the trunk muscles during seven stabilization exercises using a gym ball. Eleven healthy men (19.9 +/- 1.8 years old) without low back pain volunteered to participate in the study. Bipolar surface electrodes were attached to the right side of the upper and lower rectus abdominis, the obliquus externus abdominis and the upper and lower back extensor muscles. EMG signals were recorded during seven types of stabilization exercises using a gym ball and normalized to maximal voluntary contraction (% MVC). A two-way analysis of variance (ANOVA) was performed on % MVC from each task for each of the five trunk muscle sites (p < 0.05). Push-up exercise, supporting with both hands on the gym ball and toes on the floor in prone position, resulted in the highest activity of all abdominal muscles, and an exercise of the lifting the gym ball up, holding it actively between both legs with both knees flexed in supine position resulted in the lowest. Lifting up of the pelvis in a bridged position exercise, supporting the head with the gym ball and with the feet on the floor in supine position, resulted in higher muscle activity of the back extensor muscles than another exercise. It is very important for physical therapists to make clear the purpose of the trunk stabilization exercises, because different kinds of exercises with the gym ball demand various levels of muscular activity and use of various parts of the trunk muscles.     

Maximal oxygen uptake,maximal voluntary isometric contraction and physical activity in young Danish adults

Summary The purpose of this study was to determine and compare interactions between the abdominal musculature and intea-abdominal pressure (IAP) during controlled dynamic and static trunk muscle loading. Myoelectric activity was recorded in six subjects from the rectus abdominis, obliquus externus, obliquus internus, transversus abdominis and erector spinae muscles using surface and intea-muscular fine-wire electrodes. The IAP was recorded intea-gastrically. Trunk flexions and extensions were performed lying on one side on a swivel table. An adjustable brake provided different friction loading conditions, while adding weights to an unbraked swivel table afforded various levels of inertial loading. During trunk extensions at all friction loads, IAP was elevated (1.8–7.2 kPa) with concomitant activity in transversus abdominis and obliquus internus muscles — little or no activity was seen from rectus abdomin is and obliquus externus muscles. For inertia loading during trunk extension, IAP levels were somewhat lower (1.8–5.6 kPa) and displayed a second peak when abdominal muscle activity occurred in the course of decelerating the movement. For single trunk flexions with friction loading, IAP was higher than that seen in extension conditions and increased with added resistance. For inertial loading during trunk flexion, IAP showed two peaks, the larger first peak matched peak forward acceleration and general abdominal muscle activation, while the second corresponded to peak deceleration and was accompanied by activity in transversus abdominis and erector spinae muscles. It was apparent that different loading strategies produced markedly different patterns of response in both trunk musculature and intea-abdominal pressure.     

Fast voluntary trunk flexion movements in standing: motor patterns

The electromyographical (EMG) activity was studied during voluntary flexion movements of the trunk in erect standing man. The movements were performed at maximal velocity with successively increasing amplitude to cover the whole range of motion. The EMG activity was recorded from agonist-antagonist pairs of muscles at the ankle, knee, hip and trunk. The angular displacements at the corresponding joints were recorded using a Selspot optoelectronic system. The duration of initiating activity in prime movers (rectus abdominis and rectus femoris) as well as time to onset of activity in muscles braking the primary movement (erector spinae, gluteus maximus and hamstrings) were highly correlated with amplitude, duration, peak velocity and time to peak velocity of the movement (r = 0.59-0.91). The corresponding correlations for peak acceleration and deceleration of the movement were low (r = 0.03-0.38), indicating that acceleration and deceleration of a movement was not coded in the temporal aspects of the EMG. Onset of activity in rectus abdominis and rectus femoris as well as an early appearing burst of activity in vastus lateralis were invariant in relation to start of movement over the whole movement range. In the initial phase of a fast trunk flexion, activity in tibialis anterior appeared successively earlier with increasing movement amplitude. This resulted in a changed order of activation for the muscles from proximal to distal (rectus abdominis first) to distal to proximal (tibialis anterior first). Two different forms of associated postural adjustments are present during a fast trunk flexion, one early fast knee flexion and a later slower angle extension. Prior to knee flexion, no activity was recorded from muscles flexing at the knee implying that some other force must create a flexing torque around the knee. It is suggested that activity in rectus abdominis initiating the primary movement also initiates knee flexion through the upward pulling of pelvis. This would be possible since rectus femoris stabilizes the pelvis in relation to the leg, allowing the force in rectus abdominis to be transmitted below the hip joint and act extending around the ankle joint. However, when tibialis anterior is activated it stabilizes the shank which in turn will cause a knee flexion controlled by a lengthening contraction in vastus lateralis. During the subsequent ankle extension activity appears in lateral gastrocnemius and soleus causing the associated postural adjustment at the ankle. It can be concluded that activation of postural muscles prior to prime mover muscles is not always necessary.(ABSTRACT TRUNCATED AT 400 WORDS)     

骨盆垂直不稳定性骨折的生物力学研究

目的　利用人体骨盆标本制作骶髂关节骨折脱位模型,研究垂直不稳定性骨盆骨折中骶髂复合体生物力学损伤特点。 方法　成年男性冰冻骨盆标本6具,固定于MTS生物材料试验机上以2 m/s速度进行动态撞击,记录骶髂关节出现完全骨折脱位所需的最大撞击力及响应时间,用步态分析仪的动作捕捉系统测量骶髂复合体中韧带完全破坏时骶髂关节空间三维位移,解剖学方法观察骶髂复合体损伤特点。 结果　成功制备出骶髂关节骨折、脱位损伤模型,单侧骶髂复合体完全损伤所需的撞击力峰值平均值（4.05±0.42）kN,标本响应时间平均值为（22.99±1.89）ms,骶髂关节最大垂直位移平均为（8.15±1.34）　mm;骶髂复合体损伤以经骶髂关节骨折并脱位为多,髂腰韧带均表现为连同第四、五腰椎横突骨折,骶髂腹侧韧带相对薄弱易于髂骨止点处撕裂,骶髂后短韧带易发生髂骨侧的撕脱骨折,骶棘韧带骶结节韧带及盆底肌肉损伤不明显。 结论 骨盆垂直不稳定性骨折中骶髂复合体损伤具有一定的规律和特点,当骶髂关节垂直位移超过0.9 cm时提示后方骶髂复合体的韧带结构已全部破坏,骨盆环处于绝对不稳状态。     

Trunk muscle coordination in reaction to load-release in a position without vertical postural demand

The aim of this study was to investigate the coordination between the innermost muscle layer of the ventro-lateral abdominal wall, the transversus abdominis (TrA), and other trunk muscles, in reaction to a load-release without the postural demand of keeping the trunk upright. Eleven healthy male volunteers participated. Intramuscular fine-wire electromyography (EMG) was obtained bilaterally from the TrA, rectus abdominis (RA), obliquus externus (OE) and erector spinae (ES) muscles. The subjects lay on their right side on a horizontal swivel-table with immobilized pelvis and lower limbs and with the trunk strapped to a movable platform allowing for trunk flexion and extension. Subjects maintained trunk flexion or extension at different force levels against a static resistance, which was suddenly released. They were instructed to resume the start position as fast as possible. EMG signals were analysed with respect to amplitude and timing of muscle activation. Following released static flexion, TrA increased its activity in synergy with ES. Also in released static extension, TrA increased its activity, but now in synergy with RA and OE. The direction-independent activation of TrA indicates a role of this muscle in controlling inter-segmental movements of the lumbar spine. This function was not accompanied by an early activation of TrA as has been shown previously for trunk perturbations in standing, i.e. a situation with an additional demand of maintaining the trunk posture upright against gravity.     

Central programming of postural movements: adaptation to altered support-surface configurations

We studied the extent to which automatic postural actions in standing human subjects are organized by a limited repertoire of central motor programs. Subjects stood on support surfaces of various lengths, which forced them to adopt different postural movement strategies to compensate for the same external perturbations. We assessed whether a continuum or a limited set of muscle activation patterns was used to produce different movement patterns and the extent to which movement patterns were influenced by prior experience. Exposing subjects standing on a normal support surface to brief forward and backward horizontal surface perturbations elicited relatively stereotyped patterns of leg and trunk muscle activation with 73- to 110-ms latencies. Activity began in the ankle joint muscles and then radiated in sequence to thigh and then trunk muscles on the same dorsal or ventral aspect of the body. This activation pattern exerted compensatory torques about the ankle joints, which restored equilibrium by moving the body center of mass forward or backward. This pattern has been termed the ankle strategy because it restores equilibrium by moving the body primarily around the ankle joints. To successfully maintain balance while standing on a support surface short in relation to foot length, subjects activated leg and trunk muscles at similar latencies but organized the activity differently. The trunk and thigh muscles antagonistic to those used in the ankle strategy were activated in the opposite proximal-to-distal sequence, whereas the ankle muscles were generally unresponsive. This activation pattern produced a compensatory horizontal shear force against the support surface but little, if any, ankle torque. This pattern has been termed the hip strategy, because the resulting motion is focused primarily about the hip joints. Exposing subjects to horizontal surface perturbations while standing on support surfaces intermediate in length between the shortest and longest elicited more complex postural movements and associated muscle activation patterns that resembled ankle and hip strategies combined in different temporal relations. These complex postural movements were executed with combinations of torque and horizontal shear forces and motions of ankle and hip joints. During the first 5-20 practice trials immediately following changes from one support surface length to another, response latencies were unchanged. The activation patterns, however, were complex and resembled the patterns observed during well-practiced stance on surfaces of intermediate lengths.(ABSTRACT TRUNCATED AT 400 WORDS)     

Anticipatory postural adjustments while sitting: The effects of different leg supports

The aim of this study was twofold, to analyze the effects of changes in body position and changes in the location of body supports on anticipatory postural adjustments (APAs). Eight healthy subjects were studied while sitting and standing. Subjects exerted upward or downward vertical force against an object attached to a rigid frame and released the object with a fast bilateral shoulder abduction movement. While sitting, four support conditions were studied: with and without feet support, and with anterior or posterior lower-leg supports. The electromyographic activity of leg and trunk muscles was recorded and quantified for APA activity. APAs in sitting with feet support were attenuated in the leg muscles (tibialis anterior, soleus, rectus femoris, and biceps femoris) but not in trunk muscles (erector spinae, rectus abdominis) when compared with standing. In the sitting task, series with and without feet support showed no difference in APAs. Anterior or posterior supports to the lower legs while sitting were associated with enhanced anticipatory activity in biceps femoris and rectus femoris muscles, respectively. However, trunk muscles showed similar anticipatory patterns across all the support conditions. We conclude that the central nervous system uses flexible, adaptive control strategies to adjust APAs to particular mechanical conditions induced by modification of a leg support.     

Trunk muscle reactions to sudden unexpected and expected perturbations in the absence of upright postural demand

The aim was to increase the understanding of the multifunctional role of the trunk muscles in spine control, particularly transversus abdominis (TrA). In 11 healthy males, intramuscular fine-wire electromyography (EMG) was obtained bilaterally from TrA, obliquus externus (OE), rectus abdominis (RA) and erector spinae (ES). The subjects lay on their right side on a horizontal swivel-table with immobilized pelvis and lower limbs and the trunk strapped to a movable platform. Unexpected or expected release of loads attached to the table by steel cables produced a perturbation inducing either trunk flexion or extension. The timing and the amplitude of activation of TrA were independent of direction of induced trunk movement. Furthermore, timing of TrA activation was simultaneous to or later than that of the more superficial abdominal muscles. Expectation of the perturbation caused a general shortening of onset latencies. The results indicate a direction independent function of TrA in lumbar spine control. Balancing the trunk vertically appears to add specific demands, since the recruitment of TrA in relation to the other abdominal muscles differed from earlier experiments in standing.     

The influence of sudden perturbations on trunk muscle activity and intra-abdominal pressure while standing

Unexpected ventral and dorsal perturbations and expected, self-induced ventral perturbations were delivered to the trunk by suddenly loading a vest strapped to the torso. Six male subjects were measured for intra-abdominal pressure (IAP) and intra-muscular electromyography of the transversus abdominis (TrA), obliquus internus abdominis (OI), obliquus externus abominis (OE) and rectus abdominis (RA) muscles. Erector spinae (ES) activity was recorded using surface electromyography. Displacements of the trunk and head were registered using a video-based system. Unexpected ventral loading produced activity in TrA, OI, OE and RA, and an IAP increase well in advance of activity from ES. Expected ventral loading produced pre-activation of all muscles and an increased IAP prior to the perturbation. The TrA was always the first muscle active in both the unexpected and self-loading conditions. Of the two ventral loading conditions, forward displacement of the trunk was significantly reduced during the self-loading. Unexpected dorsal loading produced coincident activation of TrA, OI, OE, RA and ES. These results indicate a response of the trunk muscles to sudden expected and unexpected ventral loadings other than the anticipated immediate extensor torque production through ES activation. It is suggested that the increase in IAP is a mechanism designed to improve the stability of the trunk through a stiffening of the whole segment.     

Task specificity in the control of intrinsic trunk muscles in man

The human trunk is a complex mechanical system comprised of large and small segments interconnected with several layers of muscles. An accurate control of this system is important during a variety of everyday tasks such as voluntary movements of the trunk, walking and running. This study was designed to investigate the interaction between muscles controlling the pelvis and the trunk during a variety of movements requiring a finely tuned coordination. Four subjects carried out seven different forms of fast oscillatory movements of the pelvis and trunk in the sagittal and transverse planes. Electromyographical activity (EMG) was recorded with surface electrodes from the abdominal muscles rectus abdominis (RA), obliquus externus (OE), obliquus internus (OI), and erector spinae (ES), from the hip flexor muscle rectus femoris (RF), the hip extensor muscle gluteus maximus (GM) and from the hip extensor/knee flexor muscles of the hamstrings group (HAM). Movements were recorded with an optoelectronic system (Selspot). The results indicate that during spontaneous flexion-extension movements of the trunk there was a basic alternating activation between a pure flexor (RF-RA-OE-OI) and an extensor synergy (ES-GM-HAM). Different mixed synergies appeared when more specific patterns of coordination of the pelvis and spine were performed. For example, during pelvic tilts in the sagittal plane, RA-OE-OI-GM formed a synergy which was activated reciprocally with ES. The neural circuitry controlling muscles of the pelvis and trunk is apparently adaptable to a variety of different tasks. Individual muscles were shown to either cause, brake or prevent a movement and to be integrated in several different task-specific motor synergies.(ABSTRACT TRUNCATED AT 250 WORDS)     

Anatomy and biomechanics of gluteus maximus and the thoracolumbar fascia at the sacroiliac joint

Biomechanical models predict that recruitment of gluteus maximus (GMax) will exert a compressive force across the sacroiliac joint (SIJ), yet this muscle requires morphologic assessment. The aims of this study were to document GMax's proximal attachments and assess their capacity to generate forces including compressive force at the SIJ. In 11 embalmed cadaver limbs, attachments of GMax crossing the SIJ were dissected and their fascicle orientation, length and attachment volume documented. The physiological cross‐sectional area (PCSA) of each attachment was calculated along with its estimated maximum force at the SIJ and lumbar spine. GMax fascicles originated from the gluteus medius fascia, ilium, thoracolumbar fascia, erector spinae aponeurosis, sacrum, coccyx, dorsal sacroiliac and sacrotuberous ligaments in all specimens. Their mean fascicle orientation ranged from 32 to 45° below horizontal and mean length from 11 to 18 cm. The mean total PCSA of GMax was 26 cm² (range 16–36), of which 70% crossed the SIJ. The average maximum force predicted to be generated by GMax's total attachments crossing each SIJ was 891 N (range 572–1,215), of which 70% (702 N: range 450–1,009) could act perpendicular to the plane of the SIJ. The capacity of GMax to generate an extensor moment at lower lumbar segments was estimated at 4 Nm (range 2–9.5). GMax may generate compressive forces at the SIJ through its bony and fibrous attachments. These may assist effective load transfer between lower limbs and trunk. Clin. Anat. 27:234–240, 2014. © 2013 Wiley Periodicals, Inc.     

老年健康女性盆底肛提肌有限元模型的建立及意义

为建立老年健康女性盆底肛提肌有限元模型(FEM),对一老年未孕女性健康志愿者进行骨盆CT及MRI薄层扫描,获得其骨盆及盆底肛提肌的原始图像数据,随后应用Mimics12.0及Geomagic9.0图像处理软件将骨盆诸骨、肛提肌及其相关肌肉进行三维重建和网格优化,在Ansys11.0软件平台上构建骨盆与肛提肌群的肌骨系统FEM,并最终获得精确的老年健康女性盆底肛提肌及骨盆的FEM。结果表明:采用CT及MRI薄层扫描数据建立的FEM真实可靠,能逼真反应盆底肛提肌的空间立体解剖关系,避免了已往依赖于尸体标本解剖获得模型的缺点,所获得的模型数据更加接近于活体解剖,有利于后期的有限元分析。     

3-D finite element analysis of the influence of synovial condition in sacroiliac joint on the load transmission in human pelvic system

The anterior part of the sacroiliac joint (SIJ) is a synovial joint, with little gliding and rotary movement between the contact surfaces of SIJ during locomotion. Due to its complex structure, especially when considering the surrounding ligaments, it is difficult to construct an accurate three-dimensional (3-D) finite element model for the human pelvis. Most of the pelvic models in the previous studies were simplified with either SIJ fusing together or without the sacral bone. However, the influence of those simplifications on the load transmission in human pelvis has not been studied, so the reliability of those studies remains unclear. In this study, two 3-D pelvic models were constructed: an SIJ fusing model and an SIJ contacting model. In the SIJ fusing model, the SIJ interfaces were fused together. In the SIJ contacting model, the SIJ interfaces were just in contact with each other without fusion. Compared with the SIJ contacting model, the SIJ fusing model have smaller movements in the SIJ. The stress distribution area in the SIJ fusing model on sacroiliac cartilages was also different. Those differences contributed to the decline of tensile force in the SIJ surrounding ligaments and the re-distribution of stress in the pelvic bones. In addition, the SIJ fusing model was far less sensitive to the increase in modulus of the sacroiliac cartilages, and decrease in stiffness of the ligaments surrounding the SIJ. The presence of synovia in the SIJ had greater influence on the load transmission in the human pelvic system. Therefore, the effect of the presence of synovia should not be neglected when the biomechanical behavior of human pelvis is being studied, especially for those studies related to clinical applications.     

Perturbed upper limb movements cause short-latency postural responses in trunk muscles

Addition of a load to a moving upper limb produces a perturbation of the trunk due to transmission of mechanical forces. This experiment investigated the postural response of the trunk muscles in relation to unexpected limb loading. Subjects performed rapid, bilateral shoulder flexion in response to a stimulus. In one third of trials, an unexpected load was added bilaterally to the upper limbs in the first third of the movement. Trunk muscle electromyography, intra-abdominal pressure and upper limb and trunk motion were measured. A short-latency response of the erector spinae and transversus abdominis muscles occurred approximately 50 ms after the onset of the limb perturbation that resulted from addition of the load early in the movement and was coincident with the onset of the observed perturbation at the trunk. The results provide evidence of initiation of a complex postural response of the trunk muscles that is consistent with mediation by afferent input from a site distant to the lumbar spine, which may include afferents of the upper limb.